Mental Health App Evaluation: Updating the American Psychiatric Association's Framework Through a Stakeholder-Engaged Workshop.

The app evaluation framework of the American Psychiatric Association (APA) has emerged as an adaptable tool for those seeking to navigate the ever-growing space of mental health apps. The authors describe a meeting convened in December 2019 to refine the APA framework. The expert panel comprised 16 individuals across health care fields, with representation from psychiatry, psychology, social work, nursing, clinical informatics, peer support specialists, and individuals with lived mental health experience. This meeting resulted in an update to the APA framework with the addition of clearer question descriptions and the release of an eight-question screener that may be useful in clinical settings.

An examination of adherence strategies and challenges in poison control communication.

INTRODUCTION: The principal objective of this study was to characterize how nurses and pharmacists at a poison control center (PCC) determine the likelihood of caller adherence to a health care facility referral. METHODS: A focus group was conducted with 6 nurses and 4 pharmacists from a regional PCC. Content analysis was used to determine themes within the discussion. All participants were certified as specialists in poison information (SPIs). RESULTS: Four themes were identified: (1) SPIs' generation of informal "likelihood-of-adherence" assessments as to whether a caller will follow the recommendation to go to a health care facility, (2) SPI communication strategies used to promote adherence, (3) behavior of SPIs during periods of high call volume, and (4) communication training for PCC staff members. DISCUSSION: This pilot study provides insights in SPIs' current assessment and communication, particularly those related to promoting caller adherence to recommendations.

Poison control center communication and impact on patient adherence.

OBJECTIVE: This project explored the communication processes associated with poison control center calls. METHODS: In this preliminary study, we adapted the Roter Interaction Analysis System to capture staff-caller dialogue. This involved case selection, wherein adherence and non-adherence cases were selected; call linkage to medical records, where case records were linked with voice recordings; and application of Roter Interaction Analysis System to calls. RESULTS: Results indicate that communications are predominantly provider-driven. Patient age and percentage of staff partnership statements were significantly associated with adherence at the 0.05 level. Increases in age were associated with decreases in adherence to recommendations (p < 0.001). Increases in percentage of staff partnership statements (over all staff talk) were associated with increases in adherence (p = 0.013). CONCLUSION: This line of research could lead to evidence-based guidelines for effective staff-caller communication, increased adherence rates, and improved health outcomes.

Readiness to change and risk drinking women.

The predictive value of the Readiness to Change Questionnaire (RTCQ) for subsequent drinking was evaluated in 499 women. These women had medical problems potentially exacerbated by alcohol use and were enrolled in an intervention study. Correlates and predictors of stage of change were analyzed. Results indicated that the categorical application of the RTCQ did not predict drinking in the 6-12 months after enrollment. Preliminary findings support rescoring the RTCQ into a continuous measure. Following this conversion, situational risks factors for drinking were examined as potential mediators of readiness to change (RTC). Heightened risk for alcohol consumption during argument or boredom was found to attenuate the association between one's RTC and later drinking. Finally, medical condition moderated the association of RTC on later drinking; women with diabetes, infertility, or osteoporosis drank the most in the contemplation stage. In contrast, hypertensive women drank more when action oriented to change. The implications for treating risk drinking in women are discussed.

Being hurt and hurting others: children's narrative accounts and moral judgments of their own interpersonal conflicts.

Children's narrative accounts and moral evaluations of their own interpersonal conflicts with peers were examined. Girls and boys (N = 112) in preschool (M= 4.8 years), first grade (M = 6.9 years), fifth grade (M = 10.9 years), and tenth grade (M = 16.2 years) provided one narrative of a time when they had been hurt by a peer ("victim"), and one of a time when they had hurt a peer ("perpetrator"). Victim and perpetrator narratives were equally long and detailed and depicted similar types of harmful behaviors, but differed significantly in terms of various measures of content and coherence. Narratives given from the victim's perspective featured a self-referential focus and a fairly coherent structure. When the same children gave accounts of situations in which they had been the perpetrators, their construals were less coherent and included multiple shifts between references to their own experience and the experience of the other. Children's moral judgments also varied by perspective, with the majority of victims making negative judgments and nearly half the perpetrators making positive or mixed judgments. These differences in moral judgments were related to the distinct ways in which victims and perpetrators construed conflict situations. Age differences were also found in both narrative construals and moral evaluations, but regardless of their age children construed conflict situations differently from the victim's and the perpetrator's perspectives. By integrating, within the study of moral development, children's interpretations of the social interactions that are at the basis of moral thinking, this approach brings us a step closer to conceptualizing the study of children's moral behavior.